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A bill to be entitled 1
An act relating to specific medical diagnoses in child 2
protective investigations; amending s. 39.301, F.S.; 3
providing an exception to the requirement that the 4
Department of Children and Families immediately 5
forward certain allegations to a law enforcement 6
agency; requiring a child protective investigator to 7
inform the subject of an investigation of a certain 8
duty; conforming a cross -reference; amending s. 9
39.303, F.S.; requiring Child Protection Teams to 10
consult with a licensed physician or advanced practice 11
registered nurse when evaluating certain reports; 12
conforming provisions to changes made by the act; 13
amending s. 39.304, F.S.; authorizing, under a certain 14
circumstance, a parent or legal custodian from whom a 15
child was removed to request specified examinations of 16
the child; requiring that certain examinations be paid 17
for by the parent or legal custodian making the 18
request or as otherwise covered by insurance o r 19
Medicaid; prohibiting the request of an examination 20
for a specified purpose; providing an effective date. 21
22
Be It Enacted by the Legislature of the State of Florida: 23
24
Section 1. Paragraph (a) of subsection (2), paragraph (a) 25
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of subsection (5), and paragraph (c) of subsection (14) of 26
section 39.301, Florida Statutes, are amended to read: 27
39.301 Initiation of protective investigations. — 28
(2)(a) The department shall immediately forward 29
allegations of criminal conduct to the municipal or county law 30
enforcement agency of the municipality or county in which the 31
alleged conduct has occurred . However, the department need not 32
immediately forward allegations of criminal conduct to the 33
appropriate law enforcement agency if the parent or legal 34
custodian: 35
1. Has alleged that the child has a preexisting diagnosis 36
specified in s. 39.303(4)(b); or 37
2. Is requesting that the child have an examination under 38
s. 39.304(1)(c). 39
40
Allegations of criminal conduct that are not immediately 41
forwarded to the law enforceme nt agency pursuant to subparagraph 42
1. or subparagraph 2. must be immediately forwarded to the law 43
enforcement agency upon completion of the investigation under 44
this part if criminal conduct is still alleged . 45
(5)(a) Upon commencing an investigation under this part, 46
the child protective investigator shall inform any subject of 47
the investigation of the following: 48
1. The names of the investigators and identifying 49
credentials from the department. 50
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2. The purpose of the investigation. 51
3. The right to obtai n his or her own attorney and ways 52
that the information provided by the subject may be used. 53
4. The possible outcomes and services of the department's 54
response. 55
5. The right of the parent or legal custodian to be 56
engaged to the fullest extent possible in determining the nature 57
of the allegation and the nature of any identified problem and 58
the remedy. 59
6. The duty of the parent or legal custodian to report any 60
change in the residence or location of the child to the 61
investigator and that the duty to repo rt continues until the 62
investigation is closed. 63
7. The duty of the parent or legal custodian to report any 64
preexisting diagnosis for the child which is specified in s. 65
39.303(4)(b) and provide any medical records that support that 66
diagnosis in a timely m anner. 67
(14) 68
(c) The department, in consultation with the judiciary, 69
shall adopt by rule: 70
1. Criteria that are factors requiring that the department 71
take the child into custody, petition the court as provided in 72
this chapter, or, if the child is not ta ken into custody or a 73
petition is not filed with the court, conduct an administrative 74
review. Such factors must include, but are not limited to, 75
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noncompliance with a safety plan or the case plan developed by 76
the department, and the family under this chapte r, and prior 77
abuse reports with findings that involve the child, the child's 78
sibling, or the child's caregiver. 79
2. Requirements that if after an administrative review the 80
department determines not to take the child into custody or 81
petition the court, the department shall document the reason for 82
its decision in writing and include it in the investigative 83
file. For all cases that were accepted by the local law 84
enforcement agency for criminal investigation pursuant to 85
subsection (2), the department must incl ude in the file written 86
documentation that the administrative review included input from 87
law enforcement. In addition, for all cases that must be 88
referred to Child Protection Teams pursuant to s. 39.303(5) and 89
(6) s. 39.303(4) and (5) , the file must includ e written 90
documentation that the administrative review included the 91
results of the team's evaluation. 92
Section 2. Present subsections (4) through (10) of section 93
39.303, Florida Statutes, are redesignated as subsections (5) 94
through (11), respectively, a new subsection (4) is added to 95
that section, and subsection (3) and present subsections (5) and 96
(6) of that section are amended, to read: 97
39.303 Child Protection Teams and sexual abuse treatment 98
programs; services; eligible cases. — 99
(3) The Department of Health shall use and convene the 100
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Child Protection Teams to supplement the assessment and 101
protective supervision activities of the family safety and 102
preservation program of the Department of Children and Families. 103
This section does not remove or reduce t he duty and 104
responsibility of any person to report pursuant to this chapter 105
all suspected or actual cases of child abuse, abandonment, or 106
neglect or sexual abuse of a child. The role of the Child 107
Protection Teams is to support activities of the program and to 108
provide services deemed by the Child Protection Teams to be 109
necessary and appropriate to abused, abandoned, and neglected 110
children upon referral. The specialized diagnostic assessment, 111
evaluation, coordination, consultation, and other supportive 112
services that a Child Protection Team must be capable of 113
providing include, but are not limited to, the following: 114
(a) Medical diagnosis and evaluation services, including 115
provision or interpretation of X rays and laboratory tests, and 116
related services, as nee ded, and documentation of related 117
findings. 118
(b) Telephone consultation services in emergencies and in 119
other situations. 120
(c) Medical evaluation related to abuse, abandonment, or 121
neglect, as defined by policy or rule of the Department of 122
Health. 123
(d) Such psychological and psychiatric diagnosis and 124
evaluation services for the child or the child's parent or 125
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parents, legal custodian or custodians, or other caregivers, or 126
any other individual involved in a child abuse, abandonment, or 127
neglect case, as the t eam may determine to be needed. 128
(e) Expert medical, psychological, and related 129
professional testimony in court cases. 130
(f) Case staffings to develop treatment plans for children 131
whose cases have been referred to the team. A Child Protection 132
Team may provide consultation with respect to a child who is 133
alleged or is shown to be abused, abandoned, or neglected, which 134
consultation shall be provided at the request of a 135
representative of the family safety and preservation program or 136
at the request of any other professional involved with a child 137
or the child's parent or parents, legal custodian or custodians, 138
or other caregivers. In every such Child Protection Team case 139
staffing, consultation, or staff activity involving a child, a 140
family safety and preservation program representative shall 141
attend and participate. 142
(g) Case service coordination and assistance, including 143
the location of services available from other public and private 144
agencies in the community. 145
(h) Such training services for program and other e mployees 146
of the Department of Children and Families, employees of the 147
Department of Health, and other medical professionals as is 148
deemed appropriate to enable them to develop and maintain their 149
professional skills and abilities in handling child abuse, 150
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abandonment, and neglect cases. The training service must 151
include training in the recognition of and appropriate responses 152
to head trauma and brain injury in a child under 6 years of age 153
as required by ss. 402.402(2) and 409.988. 154
(i) Educational and communi ty awareness campaigns on child 155
abuse, abandonment, and neglect in an effort to enable citizens 156
more successfully to prevent, identify, and treat child abuse, 157
abandonment, and neglect in the community. 158
(j) Child Protection Team assessments that include, as 159
appropriate, medical evaluations, medical consultations, family 160
psychosocial interviews, specialized clinical interviews, or 161
forensic interviews. 162
163
A Child Protection Team that is evaluating a report of medical 164
neglect and assessing the health care needs of a medically 165
complex child shall consult with a physician who has experience 166
in treating children with the same condition. 167
(4) A Child Protection Team shall consult with a physician 168
licensed under chapter 458 or chapter 459 or an advanced 169
practice registered nurse licensed under chapter 464 who has 170
experience in and routinely provides medical care to pediatric 171
patients when evaluating a report of: 172
(a) Medical neglect and assessing the needs of a medically 173
complex child; or 174
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(b) A child with a repo rted preexisting diagnosis of any 175
of the following: 176
1. Rickets. 177
2. Ehlers-Danlos syndrome. 178
3. Osteogenesis imperfecta. 179
4. Vitamin D deficiency. 180
5. Any other medical condition known to appear to be 181
caused by, or known to be misdiagnosed as, abuse. 182
(6)(5) All abuse and neglect cases transmitted for 183
investigation to a circuit by the hotline must be simultaneously 184
transmitted to the Child Protection Team for review. For the 185
purpose of determining whether a face -to-face medical evaluation 186
by a Child Protection Team is necessary, all cases transmitted 187
to the Child Protection Team which meet the criteria in 188
subsection (5) (4) must be timely reviewed by: 189
(a) A physician licensed under chapter 458 or chapter 459 190
who holds board certification in pe diatrics and is a member of a 191
Child Protection Team; 192
(b) A physician licensed under chapter 458 or chapter 459 193
who holds board certification in a specialty other than 194
pediatrics, who may complete the review only when working under 195
the direction of the Ch ild Protection Team medical director or a 196
physician licensed under chapter 458 or chapter 459 who holds 197
board certification in pediatrics and is a member of a Child 198
Protection Team; 199
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(c) An advanced practice registered nurse licensed under 200
chapter 464 who has a specialty in pediatrics or family medicine 201
and is a member of a Child Protection Team; 202
(d) A physician assistant licensed under chapter 458 or 203
chapter 459, who may complete the review only when working under 204
the supervision of the Child Protection Team medical director or 205
a physician licensed under chapter 458 or chapter 459 who holds 206
board certification in pediatrics and is a member of a Child 207
Protection Team; or 208
(e) A registered nurse licensed under chapter 464, who may 209
complete the review only when working under the direct 210
supervision of the Child Protection Team medical director or a 211
physician licensed under chapter 458 or chapter 459 who holds 212
board certification in pediatrics and is a member of a Child 213
Protection Team. 214
(7)(6) A face-to-face medical evaluation by a Child 215
Protection Team is not necessary when: 216
(a) The child was examined for the alleged abuse or 217
neglect by a physician who is not a member of the Child 218
Protection Team, and a consultation between the Child Protection 219
Team medical director or a Child Protection Team board -certified 220
pediatrician, advanced practice registered nurse, physician 221
assistant working under the supervision of a Child Protection 222
Team medical director or a Child Protection Team board -certified 223
pediatrician, or registered nurse working under the direct 224
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supervision of a Child Protection Team medical director or a 225
Child Protection Team board -certified pediatrician, and the 226
examining physician concludes that a further medical evaluation 227
is unnecessary; 228
(b) The child protective investigator, with supervisory 229
approval, has determined, after conducting a child safety 230
assessment, that there are no indications of injuries as 231
described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or 232
(c) The Child Protection Team medical director or a Child 233
Protection Team board -certified pediatrician, as authorized in 234
subsection (6) (5), determines that a medical evaluation is not 235
required. 236
237
Notwithstanding paragraphs (a), (b), and (c), a Child Protection 238
Team medical director or a Child Protection Team pediatrician, 239
as authorized in subsection (6) (5), may determine that a face -240
to-face medical evaluation is necessary. 241
Section 3. Paragraph (c) is added to subsection (1) of 242
section 39.304, Florida Statutes, to read: 243
39.304 Photographs, medical examinations, X rays, and 244
medical treatment of abused, abandoned, or neglected child. — 245
(1) 246
(c) If an examination is performed on a child under 247
paragraph (b), the parent or legal custodian from whom the child 248
was removed pursuant to s. 39.401 may: 249
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1. If the initial examination was not performed by the 250
Child Protection Team, request that the child be examined by the 251
Child Protection Team as soon as practicable; 252
2. If the initial examination was performed by the Child 253
Protection Team, for the purpose of obtaining a second opinion 254
on diagnosis or treatment, request that the child be examined by 255
a physician licensed under chapter 458 or chapter 459 or an 256
advanced practice registered nurse licensed under chapter 464 of 257
his or her choosing who routinely provides medical care to 258
pediatric patients; or 259
3. For the purpose of ruling out a differential diagnosis, 260
request that the child be examined by a physician licensed under 261
chapter 458 or chapter 459 or an advanced practice registered 262
nurse licensed under chapter 464 who routinely provides 263
diagnosis of and medical care to pediatric patients for the 264
conditions specified in s. 39.303(4)(b). 265
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An examination requested under subparagraph 2. or subparagraph 267
3. must be paid for by the parent or legal custodian making such 268
request or as otherwise covered by insurance or Medicaid. An 269
examination may not be requested under this paragraph for the 270
purpose of obtaining a second opinion as to whether a child has 271
been sexually abused. 272
Section 4. This act shall take effect July 1, 2025. 273